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      Methicillin-Resistant Staphylococcus aureus (MRSA) in Artisanal Cheeses in México

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          Abstract

          Milk and dairy foods have frequently been implicated in staphylococcal food poisoning, and contaminated raw milk is often involved. The aim of the study was to determine the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) in raw cow milk cheese produced in Mexico. A total of 78 unpasteurized cow milk cheese samples were screened for S. aureus. The isolates were identified as S. aureus based on morphology, Gram stain, catalase test, coagulase test, and mannitol salt agar fermentation. Isolates were subjected to biotyping, the methicillin resistance was analyzed using the disk diffusion, and the Staphylococcus enterotoxin A (SEA) production was examined by a dot-blot analysis. From a total of 78 samples of unpasteurized cheeses analyzed in this study, 44 cheeses were positive for S. aureus; however, a differential contamination between the different types of cheeses was observed, with high risk of contamination in adobero cheese (12, 95% CI 1.75 to 94.20; p=0.002). In this study, the frequency of methicillin-resistant Staphylococcus aureus (MRSA) was 18.1% (8/44) and of enterotoxin A producers was 18.1% (8/44). When classified by biotypes, MRSA only belongs to the human ecovar biotype (2/8, 25%) and the D biotype (4/8, 50%). S. aureus producers of enterotoxin A were distributed in specific nonhost biotypes.

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          Implication of milk and milk products in food-borne diseases in France and in different industrialised countries.

          Marie-Laure De Buyser, Barbara Dufour, Murielle Maire … (2001)
          A study was carried out to estimate the proportion of diseases due to milk and milk products among food-borne diseases recorded in France and in other countries since 1980. Particular attention was given to whether the milk involved was heat-treated or not. Four etiologic agents were considered: Salmonella spp., Staphylococcus aureus, Listeria monocytogenes, and pathogenic Escherichia coli. An overview of food-borne disease annual reports from seven countries indicated that milk and milk products were implicated in 1-5% of the total bacterial outbreaks; however, details about the type of product and milk involved were usually not provided. When considering 60 outbreaks and four single cases described in the literature and implicating milk and milk products, confirmed or suspected food vehicles were distributed as follows: milk, 39.1%, cheese, 53.1%, other milk products, 7.8%. Overall, 32.8% of the food vehicles were made from pasteurised milk; 37.5% from raw milk; 10.9% from milk stated as "unpasteurised"; and 18.8% from unspecified milk. Salmonella spp. were responsible for 29 outbreaks, L. monocytogenes for 10 outbreaks and four well-documented single cases, pathogenic E. coli for 11 outbreaks, and S. aureus for 10 outbreaks. Analysis of unpublished data about food-borne disease outbreaks, listeriosis excluded, collected by the coordinator of the French surveillance system from 1992 to 1997, revealed 69 documented outbreaks for which milk and milk products were confirmed as the vehicle by the isolation of the etiologic agent. The food vehicles were distributed as follows: milk, 10%; cheese, 87%; others, 3%. UHT milk accounted for 1.5%, raw milk and raw milk products for 48%, and milk and milk products from unspecified milk for 50.5% of the 69 outbreaks. S. aureus was by far the most frequent pathogen associated with these outbreaks (85.5% of the outbreaks), followed by Salmonella (10.1%). This study demonstrates the limitations of the surveillance systems and the difficulties in estimating the contribution of milk and milk products to food-borne diseases. In particular, it was not possible to find out in many outbreaks what heat treatment, if any, the milk had undergone.
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            Nasal carriage of Staphylococcus aureus and prevention of nosocomial infections.

            Jan Kluytmans, Heiman Wertheim (2005)
            This review summarizes the clinically relevant aspects of nasal carriage of Staphylococcus aureus. The epidemiology, associated risk, and the effects of eradication are discussed. The main conclusions are that nasal carriage of S. aureus is a well-defined risk factor for subsequent infection in nearly all categories of hospitalized patients that have been studied. However, studies that have been performed to evaluate the effect of eradication of carriage using mupirocin nasal ointment have been inconclusive so far in most subgroups. Only in patients on hemodialysis or chronic ambulatory peritoneal dialysis (CAPD) was a significant reduction of the infection rate found. But prolonged treatment in these groups carries a risk for the development of resistance. In surgical patients two randomized studies have found an effect on the surgical site infection rate in carriers that, when those studies are combined, was close to being statistically significant (p = 0.06). In non-surgical patients a significant delay in the onset of infection was found but the overall infection rate was not significantly different. When the results of all well-designed studies that have been performed are combined, a significant reduction of the nosocomial S. aureus infections in carriers is found (approximately 50% lower). Future studies should focus on treating carriers only and consider other treatment regimens.
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              How Should Staphylococcal Food Poisoning Outbreaks Be Characterized?

              Jacques-Antoine Hennekinne, Annick Ostyn, Florence Guillier … (2010)
              Staphylococcal food poisoning is one of the most common food-borne diseases and results from the ingestion of staphylococcal enterotoxins (SEs) preformed in food by enterotoxigenic strains of Staphylococcus aureus. To date, more than 20 SEs have been described: SEA to SElV. All SEs have superantigenic activity whereas only a few have been proved to be emetic, representing a potential hazard for consumers. Characterization of staphylococcal food poisoning outbreaks (SFPOs) has considerably progressed compared to 80 years ago, when staphylococci were simply enumerated and only five enterotoxins were known for qualitative detection. Today, SFPOs can be characterized by a number of approaches, such as the identification of S. aureus biovars, PCR and RT-PCR methods to identify the se genes involved, immunodetection of specific SEs, and absolute quantification by mass spectrometry. An integrated gene-to-protein approach for characterizing staphylococcal food poisoning is advocated.
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                Author and article information

                Contributors
                Arturo Ramirez-Peralta:
                ORCID: http://orcid.org/0000-0002-7037-6412
                Journal
                Journal ID (nlm-ta): Int J Microbiol
                Journal ID (iso-abbrev): Int J Microbiol
                Journal ID (publisher-id): IJMICRO
                Title: International Journal of Microbiology
                Publisher: Hindawi
                ISSN (Print): 1687-918X
                ISSN (Electronic): 1687-9198
                Publication date Collection: 2018
                Publication date (Electronic): 18 November 2018
                Volume: 2018
                Electronic Location Identifier: 8760357
                Affiliations
                1Laboratorio de Investigación en Patometabolismo Microbiano, Universidad Autonoma de Guerrero, Chilpancingo de los Bravo 39000, Mexico
                2Laboratorio de Investigación en Microbiologia Molecular y Biotecnologia Ambiental, Universidad Autonoma de Guerrero, Chilpancingo de los Bravo 39000, Mexico
                3Laboratorio de Investigación en Inmunobiologia y Diagnostico Molecular, Universidad Autonoma de Guerrero, Chilpancingo de los Bravo 39000, Mexico
                4Laboratorio de Investigación en Parasitologia, Universidad Autonoma de Guerrero, Chilpancingo de los Bravo 39000, Mexico
                5Laboratorio de Investigación en Analisis Microbiologicos, Universidad Autonoma de Guerrero, Chilpancingo de los Bravo 39000, Mexico
                Author notes

                Academic Editor: Barbara H. Iglewski

                Author information
                http://orcid.org/0000-0002-1375-2485
                http://orcid.org/0000-0001-8810-1401
                http://orcid.org/0000-0003-3143-3768
                http://orcid.org/0000-0001-5187-665X
                http://orcid.org/0000-0002-7037-6412
                Article
                DOI: 10.1155/2018/8760357
                PMC ID: 6276487
                SO-VID: a3252221-c978-453a-918e-50fb6e7465e9
                Copyright © Copyright © 2018 Roberto Adame-Gómez et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 16 May 2018
                Date revision received : 23 August 2018
                Date accepted : 17 September 2018
                Funding
                Funded by: Secretaria de Educación Pública, México
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Microbiology & Virology
                Data availability:
                ScienceOpen disciplines: Microbiology & Virology

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